Dr Tammy Maxwell chose to do her GP training in a rural environment, and opted to stay after achieving her fellowship. Here are the many reasons why she couldn’t think of anywhere better to live, and practice medicine, than in Dalby.
Tammy’s clinical work
While currently on maternity leave with her second child, Tammy normally splits her time between Myall Medical Practice and the local hospital in Dalby.
“I’ve always enjoyed doing a mixture of GP office-based and hospital care. In the last couple of years, I’ve spent each fortnight working three days in general practice and six days at the hospital, where I rotate between the maternity, emergency and acute wards,” she explains.
Making the decision to go rural
Tammy grew up in Landsborough, a beautiful hinterland area on the Sunshine Coast, but she also had family that lived in rural Queensland and visited them often. As a youngster, she found the health inequalities between her rural and city-based family members to be ‘very evident’.
“I was young, so I didn’t understand the health implications such as shorter lifespans and a lesser quality of life. That all became clearer as I got older and worked in medicine rurally. I suppose that early experience is what drew me to rural work initially,” she says.
During her time at medical school, the rural generalist pathway was heavily promoted as a means to help alleviate rural medical workforce shortages, and better support the health needs of rural communities. She saw it as a great way to combine her love of general practice and her interest in procedural obstetrics.
“I thought it would be a perfect model to choose. We had to apply before we actually finished medical school, so my pathway was set before I completed my studies,” she explains.
When it came time to do her GP training, Tammy picked Dalby, a thriving rural hub in the Darling Downs region.
“I thought it was a good compromise between being rural but still having access to Brisbane, which is only a three-hour drive away, especially as we have lots of family there,” she says.
She also saw it as a chance to practice her procedural skills.
“Dalby is one of the biggest maternity delivery sites in Queensland, so I knew I’d get plenty of experience and be able to solidify my procedural obstetric skills. Plus we’re only one hour away from a tertiary referral hospital by road, and chopper is much quicker than that. So even though we’re rural, we’ve still got good clinical support from our specialist colleagues in a larger centre if we need it.”
What Tammy loves about rural medicine
There are many reasons Tammy loves working rurally, and a major one is the support she gets from her colleagues.
“I’ve stayed in Dalby so long and will continue to, as I have the most amazing mentors and colleagues. I’ve really missed them while I’ve been on maternity leave, and it’s been quite hard not to get drawn back in! I have some great mates where I work and that’s been an unexpected win,” she laughs.
The other aspect of rural work that keeps Tammy motivated is the direct collaboration between her GP practice and the local hospital.
“It’s not so much an ‘us and them’ mentality, which I think is something unique to a rural environment. The continuity of care is seamless, providing me with a greater opportunity to optimally care for my patients,” she says.
This is particularly important for her maternity patients who she sees privately in her GP rooms – both for their antenatal and postnatal care – and during delivery while in hospital.
“It’s just amazing that I can do that. Everybody is so helpful and supportive of that model, so you’re not hitting roadblocks all the time. It’s a very smooth process,” she says.
The other advantage of practising rurally is that she’ll often see multiple generations which she finds ‘very rewarding’.
“You get to see your patients throughout their pregnancy, in labour and afterwards, and then when the next generation comes, you get to learn about their family too. You have a great scope of influence and while you may not believe the things you do for them are significant, to those patients they really are.”
Tammy also enjoys the feeling of community she gets by both living and working in Dalby.
“You’re definitely a well-respected member of the community. They welcome you very quickly as everyone is appreciative of you being there, and you feel valued as a clinician, which helps you stay motivated. I also live in the town and contribute, so I think that’s highly respected too,” she explains.
What she loves about rural life
Tammy grew up on a 30-acre property and while she says she didn’t live rurally, she did have a life similar to those in the country. She’s grateful her children can now experience some of the same, as her young family live on a 10-acre property where her toddler can ‘play outside and build stuff or climb trees.’
“I suppose I’ve always been drawn to this type of life, so I feel like we’re home in Dalby. We’re really settled in all aspects, from work to raising children to socialising. Every facet of our life seems to complement each other and we just love it,” she says.
While Tammy admits she doesn’t have access to a broad range of restaurants or shopping centres, she says it doesn’t bother her. If she does want to avail herself of such services, she plans ahead or shops online. There’s also another big bonus of living rurally.
“While I have to do a lot more driving, it’s all on long open roads as opposed to being stuck in traffic. I did plenty of driving when we lived in the city, but it’s at a much better speed now,” she laughs.
Rural concerns and how she overcame them
Tammy acknowledges many registrars are apprehensive about the isolation they’ll face when working rurally.
“I was worried about being the only doctor with a procedural skill available, and I’m not sure that concern ever goes away. But you do start to feel comfortable with it as you develop your contacts,” she explains. “The lovely thing about working in a rural community is that we all support each other. Almost every time I’ve called around town in an emergency, someone has dropped whatever they’ve had on, organised childcare and come in to help,” she says.
The other fear Tammy had was whether her husband would find employment, especially as he worked in access control and security systems for city buildings and stadiums. As Tammy puts it ‘there aren’t that many of them around out west!’
“He initially worked an hour away in Toowoomba but wasn’t really happy. He then took up a few different jobs in Dalby while he thought about what he wanted to do. He decided to go back to university and he’s just finished his third year of a secondary school education degree. He also works at a couple of local schools and has been offered a job for next year, which will hopefully lead to a permanent position.”
Tammy says this has worked really well for their particular situation, as her husband was able to take on a primary care role with their children while studying via correspondence. As he transitions to full-time work and Tammy returns to work next year, they use childcare options, of which there are plenty in Dalby.
The only other concern Tammy faced living rurally was whether her family would come out to see them.
“We’ve found it does take more effort to keep up, especially as years go by and people visit less and less. But that’s also a natural part of life and happens everywhere, not just in a rural town. I do find you have to be a little more organised with planning family events. But on the flip side, we don’t take our family for granted. We appreciate the time we have together because it’s limited,” she explains.
Tammy’s tips if you’re considering training rurally
- Be sure to get unbiased advice
“People often say negative things about living and working rurally, particularly those who don’t actually live in a rural town. It’s important to uncover why those people didn’t enjoy their experience – perhaps they weren’t debriefed properly, or well supported in their placement,” she says.
“Before dismissing rural work, seek out multiple people who actually live and work rurally. It’s critical to find out why they enjoy it and get unbiased advice before making your decision.”
- Try it
“Even if you’re just a little bit curious, give working rurally a go. There are so many options and jobs, as well as people who are willing to be flexible with your situation. I know it’s not for everyone for logistical reasons, but even if you try a six-month stint, it will give you a good taste of rural medicine.”
- If you decide to move, do your due diligence research-wise
“Before you arrive, thoroughly research the town you choose. There are plenty of rural Facebook groups and GP groups, plus GPTQ can connect you with people who actually live and work in that town. It’s important to understand the location, the challenges and all the things that will make your transition to rural life easier, like childcare and work options for your partner, plus where you’d like to live.”